The Extensivist will see you now

Where would you rather be—at home or in the hospital?

We’re pretty sure we know the answer to that question, which is why if you’re ever a patient at Nazareth Hospital, you may meet Genevieve Skalak, DO, FACOI.

She’s a hospital extensivist—a new kind of doctor here at Nazareth who could play a key role in keeping you well even after you head home.

A bridge to better care

Dr. Skalak’s job, in short, is to help people who have been hospitalized avoid repeat visits. That means making sure those who are at high risk for readmission—because of their illness or personal circumstances—get the care they need once they leave the hospital.

“As an extensivist, I provide a bridge between inpatient hospital care and the outpatient care that someone may still need,” Dr. Skalak explains. “It’s an additional service for patients who may need help during that vulnerable time when they’re transitioning from the hospital to home. We want to make sure patients have the support and care necessary to make that transition smoothly and safely.”

The process of figuring out who might benefit from Dr. Skalak’s help begins as soon as someone is admitted to the hospital. A nurse records the detailed health history of each patient. That history helps determine if the person is at high risk of being hospitalized again soon.

A number of things can put someone at risk for readmission. For instance, they may have conditions such as chronic obstructive pulmonary disease (COPD), diabetes or unstable heart disease that are hard to manage. They may have recently visited the Emergency Department or had a lengthy stay in the hospital. Or they may lack important support services, such as reliable transportation to medical appointments.

Nice to meet you!

Patients first meet Dr. Skalak when they’re in the hospital.

“I introduce myself and talk about my role as a Mercy physician,” she says. “I tell them I’m not here to be their primary care physician or their physician while they’re in the hospital. But I could help them once they’re discharged.”

Dr. Skalak has an office right across the street from Nazareth Hospital. Patients who agree to a follow-up visit see her within three days after leaving the hospital.

That visit may include:

A medical assessment and exam to make sure the person is doing OK since being discharged. “I want to know how someone is feeling,” Dr. Skalak says. “Are there any new symptoms, or symptoms that haven’t gotten better since their hospital stay?”

Education about the person’s illness. “Sometimes patients have a new diagnosis and education is crucial because this is an entirely new problem for them,” Dr. Skalak says.

A chance to talk about what might be getting in the person’s way of staying well, such as not using medicines correctly, not eating a healthy diet or not seeing their primary care doctor on a regular basis.

A discussion about what to do if symptoms get worse—when the person needs to call their doctor right away and when to call 911.

“The point of a visit with me is to make sure that someone is stable immediately after leaving the hospital,” Dr. Skalak says. “And to help them overcome any obstacles they may have to being well. It’s a safety net on top of their other great care.”